High dose of steroids in severe COVID-19 tied to Thyroid dysfunction: PGIMER Study

Group I (n=35) with moderate-to-severe disease including oxygen saturation less than 94% on room air or those with comorbidities.

Group II (n=49) with mild disease, with oxygen saturation >94% and without comorbidities.

Their Hypothalamo-pituitary-adrenal, thyroid, gonadal axes, and lactotroph function were assessed. Along with this, their inflammatory and cell-injury markers were also examined.

The researchers found the following:

· Group I patients showed higher prevalence of hypocortisolism (38.5 vs 6.8%, p=0.012), lower ACTH (16.3 vs 32.1pg/ml, p=0.234) and DHEAS (86.29 vs 117.8µg/dl, p= 0.086) as compared to group II patients.

· Low T3 syndrome was noted in both the groups, irrespective of disease severity.

· Sick euthyroid syndrome (apart from low T3 syndrome) and atypical thyroiditis (low T3, high T4, low or normal TSH)) was most commonly seen in group I than group II.

· Male hypogonadism was also more prevalent in group I (75.6% vs 20.6%, p=0.006) as compared to group II, with a higher prevalence of both secondary (56.8 vs 15.3%, p=0.006) and primary (18.8 vs 5.3%, p=0.006) hypogonadism.

· Lastly, hyperprolactinemia was noted in 42.4% of patients, without a significant difference between both groups.

The researchers concluded that in patients with COVID-19 various endocrine organs and axes may get involved, with a greater prevalence and degree of endocrine dysfunction in those with more severe disease.

Reference:

Spectrum of endocrine dysfunction and association with disease severity in patients with COVID-19: Insights from a cross-sectional, observational study by Das L et. al published in the frontiers of endocrinology journal.

DOI: 10.3389/fendo.2021.645787